M1046

M1046 — Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was less than 37 or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was less than 71 postoperatively

Q: What is HCPCS code M1046?

M1046 is a HCPCS Level II code for functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was less than 37 or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was less than 71 postoperatively. It sits in the Medical Services section.

Q: Does Medicare cover M1046?

The CMS HCPCS file marks M1046 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.

Q: How is M1046 paid under the physician fee schedule?

M1046 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.

HCPCSActiveBETOS Z2

M1046 is a HCPCS Level II code for functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was less than 37 or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was less than 71 postoperatively. It belongs to the Medical Services section. Whether Medicare pays it depends on the coverage rule below.

Medicare coverage: Carrier judgment

Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.

From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.

Physician fee schedule statusM

Measurement code. Used for reporting purposes only; never paid.

Global period: XXX

Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.

The CMS record for M1046

Long descriptor: Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was less than 37 or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was less than 71 postoperatively
Short descriptor: Fs oks 9-15mo < 37 < 71
Added: January 1, 2019
BETOS: Z2
Pricing indicator: 00 — Not priced by Part B

Codes adjacent to M1046

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1046 is not quite right, the correct code is very often within a few positions of it.

M1038Patients with a diagnosis of lumbar spine region fracture at the time of the procedure
M1039Patients with a diagnosis of lumbar spine region infection at the time of the procedure
M1040Patients with a diagnosis of lumbar idiopathic or congenital scoliosis
M1041Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis
M1042Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperativelyterminated
M1043Functional status was not measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively
M1044Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperativelyterminated
M1045Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was greater than or equal to 37 or knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was greater than or equal to 71
M1047Functional status was measured by the oxford knee score (oks) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperativelyterminated
M1048Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at three months (6 to 20 weeks) postoperativelyterminated
M1049Functional status was not measured by the oswestry disability index (odi version 2.1a) at three months (6 - 20 weeks) postoperatively
M1050Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at three months (6 to 20 weeks) postoperativelyterminated
M1051Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis
M1052Leg pain was not measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively
M1053Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperativelyterminated
M1054Patient had only urgent care visits during the performance period

Questions about M1046

What is HCPCS code M1046?

M1046 is a HCPCS Level II code for functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was less than 37 or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was less than 71 postoperatively. It sits in the Medical Services section.

Does Medicare cover M1046?

The CMS HCPCS file marks M1046 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.

How is M1046 paid under the physician fee schedule?

M1046 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.